Objective. The main objective is to analyze the use of mental health services in a sample of people with schizophrenia and other psychoses according to gender. Method. The sample of this observational and retrospective study ( ) consisted of all the persons who visited any mental health service of the Parc Sanitari Sant Joan de Déu from 2001 to 2007 with a diagnosis of schizophrenia and other psychoses. The main measures analyzed regarding gender were the frequency of patients for each diagnosis, their risk of being admitted into hospital, and the number and length of hospitalizations for the subsample of inpatient people during the study period. Results. Men are more frequent in the total sample (58.1%). For diagnosis of schizoaffective or delusional disorder, women have a higher frequency than men. Women with diagnosis of schizophrenia have a lower risk of being admitted to the hospital ( , 95% CI？(0.72, 0.97)). We found a higher risk of longer stays for men with schizophrenia of the disorganized type ( , 95% CI？(0.30, 0.81)), undifferentiated ( , 95% CI？(0.27, 0.61)), or delusional disorder ( , 95% CI？(0.49, 0.87)). Conclusion. Gender of patients is a relevant variable in mental health service use by patients with schizophrenia and other psychoses. 1. Introduction Gender differences in schizophrenia have received widespread empirical support with respect to incidence, age at onset, familial transmission, and neurobiological factors [1, 2]. However, gender differences in the use of mental health services have been less studied, and the results are controversial. The most studied variables are number of hospitalizations and length of hospital stay. Some researchers have found a higher number of hospitalizations and length of stays in men than women [3–5]. However, Lindamer et al. [6] found that women with schizophrenia have a higher risk of being hospitalized than men. Specifically, gender differences in the use of services with regard to the different subtypes of schizophrenia have been less explored. Beratis et al. [7] found that the frequency of men was more than three times greater than that of women in the residual and the catatonic subtypes. Tang et al. [8], using the ICD-10 classification system, found differences in the overall subtype distribution between male and female patients, with the paranoid subtype being more common in females; however, they did not explore hospitalizations regarding the subtypes of schizophrenia. On the other hand, Mimica et al. [9] found a different hospitalization pattern between subtypes of schizophrenia; the
References
[1]
A. Leung and P. Chue, “Sex differences in schizophrenia, a review of the literature,” Acta Psychiatrica Scandinavica, Supplement, vol. 101, no. 401, pp. 3–38, 2000.
[2]
K. M. Abel, R. Drake, and J. M. Goldstein, “Sex differences in schizophrenia,” International Review of Psychiatry, vol. 22, no. 5, pp. 417–428, 2010.
[3]
J. Usall, S. Araya, S. Ochoa, E. Busquets, A. Gost, and M. Márquez, “Gender differences in a sample of schizophrenic outpatients,” Comprehensive Psychiatry, vol. 42, no. 4, pp. 301–305, 2001.
[4]
P. Uggerby, R. E. Nielsen, C. U. Correll, and J. Nielsen, “Characteristics and predictors of long-term institutionalization in patients with schizophrenia,” Schizophrenia Research, vol. 131, no. 1–3, pp. 120–126, 2011.
[5]
T. M. Agbir, M. Oyigeya, M. Audu, D. D. Dapap, and S. G. Goar, “Gender and psychiatric diagnosis: a 5-year retrospective study in a Nigerian Federal Medical Centre,” Nigerian Journal of Medicine, vol. 19, no. 4, pp. 455–458, 2010.
[6]
L. A. Lindamer, A. Bailey, W. Hawthorne et al., “Gender differences in characteristics and service use of public mental health patients with schizophrenia,” Psychiatric Services, vol. 54, no. 10, pp. 1407–1409, 2003.
[7]
S. Beratis, J. Gabriel, and S. Hoidas, “Gender differences in the frequency of schizophrenic subtypes in unselected hospitalized patients,” Schizophrenia Research, vol. 23, no. 3, pp. 239–244, 1997.
[8]
Y. L. Tang, C. F. Gillespie, M. P. Epstein et al., “Gender differences in 542 Chinese inpatients with schizophrenia,” Schizophrenia Research, vol. 97, no. 1–3, pp. 88–96, 2007.
[9]
N. Mimica, N. Henigsberg, S. Uzun, T. Ljubin, Z. Folnegovi？, and V. Folnegovi？-？malc, “Catatonic schizophrenia has a shorter pre-hospitalisation interval than other types of schizophrenia,” Journal of Neural Transmission, vol. 109, no. 2, pp. 203–212, 2002.
[10]
A. H？ye, G. Rezvy, V. Hansen, and R. Olstad, “The effect of gender in diagnosing early schizophrenia: an experimental case simulation study,” Social Psychiatry and Psychiatric Epidemiology, vol. 41, no. 7, pp. 549–555, 2006.
[11]
T. H. McGlashan and K. K. Bardenstein, “Gender differences in affective, schizoaffective, and schizophrenic disorders,” Schizophrenia Bulletin, vol. 16, no. 2, pp. 319–329, 1990.
[12]
E. de Portugal, N. González, V. Miriam, J. M. Haro, J. Usall, and J. A. Cervilla, “Gender differences in delusional disorder: evidence from an outpatient sample,” Psychiatry Research, vol. 177, no. 1-2, pp. 235–239, 2010.
[13]
M. Arendt, R. Rosenberg, L. Foldager, G. Perto, and P. Munk-J？rgensen, “Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases,” British Journal of Psychiatry, vol. 187, pp. 510–515, 2005.
[14]
S. M. Cotton, M. Lambert, B. G. Schimmelmann et al., “Gender differences in premorbid, entry, treatment, and outcome characteristics in a treated epidemiological sample of 661 patients with first episode psychosis,” Schizophrenia Research, vol. 114, no. 1–3, pp. 17–24, 2009.
[15]
R. Segarra, N. Ojeda, A. Zabala, et al., “Similarities in early course among men and women with a first episode of schizophrenia and schizophreniform disorder,” European Archives of Psychiatry and Clinical Neuroscience, vol. 262, no. 2, pp. 95–105, 2012.
[16]
A. Malla, R. Norman, L. Bechard-Evans, N. Schmitz, R. Manchanda, and C. Cassidy, “Factors influencing relapse during a 2-year follow-up of first-episode psychosis in a specialized early intervention service,” Psychological Medicine, vol. 38, no. 11, pp. 1585–1593, 2008.
[17]
A. Aleman, R. S. Kahn, and J. P. Selten, “Sex differences in the risk of schizophrenia: evidence from meta-analysis,” Archives of General Psychiatry, vol. 60, no. 6, pp. 565–571, 2003.
[18]
L. Miquel, J. Usall, C. Reed et al., “Gender differences in outcomes of acute mania: a 12-month follow-up study,” Archives of Women's Mental Health, vol. 14, no. 2, pp. 107–113, 2011.
[19]
J. Usall, S. Ochoa, S. Araya, and M. Márquez, “Gender differences and outcome in schizophrenia: a 2-year follow-up study in a large community sample,” European Psychiatry, vol. 18, no. 6, pp. 282–284, 2003.
[20]
P. McGorry, “Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of schizophrenia and related disorders,” Australian and New Zealand Journal of Psychiatry, vol. 39, no. 1-2, pp. 1–30, 2005.
